With fears around the globe about a growing public health crisis as a result of increased excess weight and obesity, finding innovative, workable solutions has become more urgent for healthcare professionals and dieticians. Losing weight in a durable manner in order to avoid more serious health issues, such as cardiovascular diseases or diabetes, has become a key focus for researchers in the sector. One French firm has found a solution.

According to the World Health Organization, the prevalence of excess weight in adults and children is a problem that has steadily been on the rise for over half a century. One report published in 2022 by WHO's Regional Office for Europe has warned that obesity rates on the continent are reaching "epidemic proportions." Being overweight can, if left untreated, lead to a plethora of serious health issues from high blood pressure and excess cholesterol to coronary heart disease, diabetes, liver disease, sleep apnea syndrome, different types of cancers and many other conditions.

The acute risk for the wider population is a serious concern to health professionals. In response, the French firm Groupe Éthique & Santé (Ethics & Health Group) has developed a hybrid programme designed to reduce weight loss in a durable, sustainable manner via personalised dietetics, behavioural reeducation and nutritional guidance in a process that, using quantitative scientific evidence, brings together doctors and dieticians to achieve lasting weight reduction in patients. The innovative method is known as "Rééducation Nutritionnelle et Psycho-Comportementale" (Nutritional and Psycho Behavioural Reeducation), or RNPC.  

A therapeutic, upstream solution

Finding solutions for sustainable weight loss can, for many people, seem an insurmountable task. Many struggle to keep their weight under control, falling into a vicious cycle of unhealthy living habits, bad nutrition, too much sugar, little exercise, ending with an extreme, unsustainable diet that fails to keep the weight off long term. There are many different reasons for unhealthy weight gain. It is often a direct result of a lack of knowledge about daily calorie requirements, a reduction in physical activity, quitting smoking, stress, lack of sleep, hypothyroidism, medication, menopause in the case of women... This inevitably leads to a bad quality of life and a higher risk of weight-related illnesses.

The RNPC method aims to tackle this congenital issue of sustainability in weight loss treatments. The program is above all designed as a response to a blind spot in the medical and pharmaceutical management of patients suffering from excess weight and obesity. The idea is also to tackle the problem "upstream" to limit the threat of serious health conditions further down the line, which in turn can put avoidable, extra pressure on already struggling health services around the globe.

The RNPC method is focused on nutritional education and monitoring from both patients' doctors and dieticians and was conceived based on quantified scientific evidence published in a series of focalised studies. These include the DiOGenes study, published in the New England Journal of Medicine, which answers the fundamental question of weight stabilisation, the DiRECT study, published in The Lancet, which shows that weight loss can cure type 2 diabetes which was long thought to be incurable. The LEGACY study, published in the Journal of the American College of Cardiology, which shows that weight loss can improve the survival of patients with atrial fibrillation, and basic research such as that of Professor Gilles Mithieux's team, about the interest of diet proteins to induce an 'appetite-suppressant' effect through triggering intestinal gluconeogenesis, and published in CELL.

A combined, comprehensive approach

According to Rémy Legrand, Groupe Éthique & Santé President and founder, "the RNPC programme is not just a diet; it is a therapy in its own right that should be prescribed by doctors in the same way as a drug or a medical device and which, in contrast to a simple diet, is a short, medium and long-term method." The main tenet of the program is a combined strategy that involves a patient's GP and their RNPC dietician. The objective is to undertake an effective and safe weight loss phase, with a rapid and sufficiently large weight loss, to significantly improve the patients' health and quality of life, followed by a weight stabilisation phase allowing these results to be sustained.

In order to achieve this, the director of the RNPC center first contacts the patient's GP, as he is the one who knows best his patient's health, to get his assessment for the patient to follow the RNPC program. "First of all, there are a few medical tests that are prescribed by the attending physician and that the patient must carry out in order for us to accept to treat him/her at the RNPC centre", explains the founder. "It is a matter of safety. The results of these tests allow the dietician to adapt the treatment to the patient's condition and specific needs in the first phase of the programme. This phase corresponds to the so-called weight loss phase, which is effective, safe, and fast, given that a weight loss of 10 to 15% is essential for curing such serious chronic diseases as diabetes, atrial fibrillation, NASH and sleep apnea."

RNPC dieticians then work in tandem with a patient's GP to develop a step-by-step personalised weight loss program focused on nutrition and exercise, with regular monitoring sessions at one of the RNPC centres. "It is essential that we all continue to work together closely," underlines Rémy Legrand. "As effective as the RNPC programme and dieticians can be, if the doctor is not involved, is not supportive of the patient's life plan to lose weight and is not insisting on the importance of stabilising the weight lost, then the process becomes more complicated, both for the patient and for us."

In short, weight management is a sound investment to tackle the multitude of afore-mentioned illnesses linked to excess weight. This approach is supported by a team from the University of Glasgow led by Professor Michael Lean, who states in their paper, "Forget polypharmacy for type 2 diabetes! Weight management is a better investment" published in NDT Digest, that "the critical keystone, yet to be perfected, is long-term maintenance of that weight loss, and diet is essential, as no drugs are yet licenced for weight maintenance."